Healthcare Provider Details

I. General information

NPI: 1679927586
Provider Name (Legal Business Name): CJL COUNSELING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2016
Last Update Date: 11/07/2025
Certification Date: 11/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42 164TH ST
CALUMET CITY IL
60409-6008
US

IV. Provider business mailing address

42 164TH ST
CALUMET CITY IL
60409-6008
US

V. Phone/Fax

Practice location:
  • Phone: 312-388-1505
  • Fax:
Mailing address:
  • Phone: 312-388-1505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ELAINE SMITH
Title or Position: CEO
Credential:
Phone: 312-388-1505